Fight Aging! author proposes that philanthropists fund trials of low-cost gerotherapies
Fight Aging! author proposes that philanthropists fund trials of low-cost gerotherapies
On September 7, Fight Aging! published an essay by Reason on why testing a low-cost intervention can cost far more than the intervention itself. The author proposes that wealthy philanthropists fund initial clinical programs to generate evidence.
Gerotherapy targets the biological processes of aging and aims to reduce the risk of several age-related diseases. An intervention may be available in clinics, but establishing its effects on aging requires a separate clinical trial. Such a trial specifies in advance who will participate and what outcome will be measured: disease, physical function, or a combination of the two. For interventions that merely slow aging, Reason describes a follow-up period of at least five years to detect changes in the rates of age-related disease and death.
Reason explains the difficulty in terms of patent economics. A patent gives a manufacturer exclusive sales rights and helps it recover development costs. A low-cost intervention that is easy to copy has weak patent protection, yet testing it can be expensive. Investors have little incentive to fund a trial because all suppliers of the intervention could benefit from its findings.
“Interventions that could potentially be used to treat aging may remain on the market for decades without a sufficiently rigorous effort to establish whether they treat aging and how well.”
The essay considers reducing the cost of medical regulation, medical tourism, and self-experimentation communities. In the author's assessment, these approaches expand access to procedures, while reliable, publicly available evidence still requires an organized clinical program.
A paper by an international geroscience working group explains why such a program takes time and money. Researchers first decide whom to enroll and which treatment outcome to measure. Detecting the gradual decline in physical function with age requires following large groups over a long period. Researchers have yet to agree on a common biomarker, a laboratory measurement that can be used to assess aging. The cost of a drug and the cost of establishing its effects are therefore separate quantities.
The AFAR FAST program helps identify early indicators that could shorten the time needed for testing by analyzing samples from completed trials. Reason proposes that wealthy philanthropists fund initial clinical programs for affordable candidate interventions. In his model, philanthropists pay to generate trial data that all suppliers of the intervention can use.